Results of Rubber Band Ligation in Hemoroid Treatment

Yıl 2017, Cilt: 3 Sayı: 3, 581 - 588, 15.12.2017

Ferhat Çay Burhan Hakan Kanat Mustafa Girgin

https://doi.org/10.30569/adiyamansaglik.385968

Öz

Purpose: The aim of our study
is to evaluate patients who have undergone the Rubber Band Ligation (RBL)
procedure for hemorrhoids in our clinic between January 2015 and January 2016
retrospectively.

Methods: We retrospectively
reviewed the records of patients who underwent LBL for hemorrhoid complaints in
our clinic between January 2015 and January 2016.  Patients who were missing or whose records
were not available were not taken to work.

Findings: Twenty-five patients
underwent a rubber band ligation in our polyclinic. Because the data of the two
patients were not fully accessible, the study was performed on 23 patients. Of
the patients, 10 were female and 13 were male. The average age was 33.4
(18-67). LBL was applied to patients with symptomatic 2nd and 3rd degree
hemorrhoidal disease who wanted to be treated with non-surgical methods. 15
patients had grade 2 and 8 patients had grade 3 hemorrhoids. There were
bleeding in 16 patients (69%), prolapse in 6 patients (14%), difficulty in
defecation in 8 patients (53%), pain in 14 patients (61%) and pruritus in 11
patients (49%). There was pain in 1 case and minimal bleeding in 1 case whom
was treated with RBL.

 Results: In conclusion, LBL method is the
safest, effective, and easily applicable method and it is the most frequently
used treatment method of non-surgical treatments for hemorrhoids. However, this
method can be seen as a disadvantage that the microscopic examination of
falling hemorrhoid pakes can not be performed.

Anahtar Kelimeler

Rubber Band Ligation, hemorrhoid, hemorrhoidectomy

Hemoroit Tedavisinde Lastik Band Ligasyon Sonuçlarımız

Öz

Amaç: Çalışmamızın amacı Ocak
2015 – Ocak 2016 tarihleri arasında kliniğimizde hemoroit şikayeti nedeniyle
Lastik Band Ligasyon (LBL) yöntemi uygulanan hastaları retrospektif olarak
taramaktır. 

Materiyal Metot: Geriye dönük
olarak Ocak 2015 – Ocak 2016 tarihleri arasında kliniğimizde hemoroid şikayeti
nedeniyle LBL uygulanan hastaların kayıtları incelendi. Verileri eksik olan
veya tam olarak kayıtlarına ulaşılamayan hastalar çalışmaya alınmadı. 

Bulgular: Polikliniğimizde 25
hastaya lastik band ligasyonu uygulandı. İki hastanın verilerine tam
ulaşılamadığı için çalışma 23 hasta üzerinden yapıldı. Hastalardan 10’ u kadın, 13’ ü erkekti. Yaş ortalaması
33,4 (18-67) idi. LBL semptomatik 2. ve 3. derece hemoroidal hastalığı olan ve
cerrahi dışı yöntemlerle tedavi olmak isteyen hastalara uygulandı. 15 hastada
grade 2, 8 hastamızda grade 3 hemoroit pakesine işlem yapıldı. 16 hastada ( %
69) kanama, 6 hastada (% 14)  prolapsus,
8 hastada (% 53) dışkılama zorluğu, 14 hastada (% 61 ) ağrı ve 11 hastada da (%
49) kaşıntı şikayetleri vardı. LBL uyguladığımız hastalarımızdan 1 olguda ağrı
ve 1 olguda da minimal kanama gözlendi.

Sonuç: Sonuç olarak LBL
yönteminin güvenli, etkili, kolay uygulanabilen bir yöntem olması ve ayaktan
tedavi protokolü olduğu için hemoroitin cerrahi dışı tedavilerinden en sık
kullanılan tedavi yöntemidir. Fakat bu yöntemin uygulanma sonrasında düşen hemoroit
pakesinin mikroskopik tetkikinin yapılamaması bir dezavantaj olarak görülebilir.

Anahtar Kelimeler

Lastik Band Ligasyonu, Hemoroid, Hemoroidektomi

Kaynakça

• 1- Lohsiriwat V. Hemorrhoids: from basic pathophysiology to clinical management. World J Gastroenterol 2012;18:2009-2017.
• 2- Füzün M. Anorektal Benign Hastalıklar. Klinik Gastroenteroloji ve Hepatoloji 2007;18:991-2.
• 3- Alemdaroğlu, K.. internal hemoroidlerin tedavisinde “Rubber Band Ligation” Kolon Rektum Hast. Derg. 1991; 1: 203-207
• 4- Corman, M. L. : Colon and Rectal Surgery.Hemorrhoids,Rubber-Ring Ligation. J. B. Lippincott Company, Philadelphia, 1984, s. 48-52.
• 5- Goligher, J.: Surgery of the Anus Rectum and Colon. Haemorrhoids or Piles, Rubber Band Ligation. Fifth Edition, Bailliere Tindall, London, 1984, s.113-117.
• 6- Gordon, PH. Nivatvongs, S.: Principles and Practice of Surgery for the Colon, Rectum and Anus. Hemorrhoids, Rubber Band Ligation. Second Edition. Quality Medical Publishing, Inc. St. Louis, Missouri, 1999. s. 200-201.
• 7- Katerina K. Rubber band ligation of hemorrhoids—an Office procedure. Ann Gastroenterol 2003;16(2):159–161.
• 8- Bernal J, Enguix M, López J, García J, Trullenque R. Rubber-band ligation for hemorrhoids in a colorectal unit. A prospective study. Rev Esp Enferm Dig 2003;96:38–45.
• 9- Forlini A, Manzelli A, Quaresima S, Forlini M. Long-term result after rubber band ligation for haemorrhoids. J Colorectal Dis 2009;24(9):1007–10.
• 10- Ayman M, Amir A, Waleed H, Elyamani M, Tito A, Hosam E. Rubber band ligation for 750 cases of symptomatic hemorrhoids out of 2200 cases. World J Gastroenterol 2008;14(42):6525–6530.
• 11- Shehata A, Saleh AF, Elheny A. Clinical outcome after Doppler-guided hemorrhoidal artery ligation and rubber-band ligation for the treatment of primary symptomatic hemorrhoids. Egyptian J Surgery 2016;35:5-10.
• 12- Bonneti R, Friedman M, Goligher J. Late result of haemorrhoidectomy by ligature and excision. BMJ 1963; 11: 216-9.
• 13- Read MG, Read NW, Haynes WG, et al. A prospective study of the haemorrhoidectomy on sphincter function and feocal continence. Br J Surg 1982; 69: 396-9.
• 14- Felt-Bersma RJ, van BR, Kobrevsar M, et al. Unsuspected sphincter defect shown by anal endosonography after anorectal surgery. A prospective study. Dis Colon Rectum 1995;39: 249-53.
• 15- Janssen L. Consensus haemorrhoids. Ned Tijdschrift Goneeskd 1994;138: 2106-9.
• 16- Adamwhite DN. Markides N. Treatment of haemorrhoids with rubber band ligation. S. Afr. M. 1983;64: 585.
• 17- Salvati EP. Evaluation of ligation of hemorrhoids as an Office procedure. Dis. Colon Rectum. 10:53-56, 1967.
• 18- Marshman D, Huber PJ. Timmerman W., Simonton T., et al. : Hemoroidal ligation. A review Of efficacy. Dis. Colon Rectum. 32 : 369-371, 1989.
• 19- Alemdaroğlu K., Ulualp K.. Single session ligation treatment of bleeding hemorrhoids. Surg. Gynecol. Obstet. 1993;177 : 62-63.
• 20- İnceoğlu R. Anüs – Rekyum Hastalıkları ve Tedavisi (1. baskı). İstanbul Nobel Tıp Kitapevi, 1991. S: 1- 17.
• 21- Shanmugam V1, Thaha MA, Rabindranath KS, Campbell KL, Steele RJ, Loudon MA. Rubber band ligation versus excisional hemorrhoidectomy for hemorrhoids. Cochrane Database Syst Rev 2005;20;(3)
• 22- MacRae HM1, McLeod RS. Comparison of hemorrhoidal treatment modalities. A meta-analysis. Dis Colon Rectum. 1995; 38: 687-94.
• 23- Kanellos I, Goulimaris I, Christoforidis E, Kelpis T, Betsis D. A comparison of the simultaneous application of sclerotherapy and rubber band ligation, with sclerotherapy and rubber band ligation applied separately, for the treatment of haemorrhoids: a prospective randomized trial. Colorectal Dis. 2003;5(2):133-8.
• 24- Alemdaroğlu, K., Akçal, T. ve Buğra, D.: Kolon Rektum ve Anal Bölge Hastalıkları. Türk Kolon ve Rektum Cerrahisi Derneği yayını. istanbul, 2004, s. 150.